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HomeAddictionDrugsCocaineCoke Jaw
Coke Jaw

11 Minutes

Edited & medically reviewed by THE BALANCE Team
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Cocaine is a stimulating drug that has numerous effects on the body and the brain. Another of the less well-known but rather conspicuous side effects of cocaine use is something that people often call ‘coke jaw.’ This condition is a clear sign of how the drug can affect the muscles and nerves of the face, especially those of the jaw. 

Let’s briefly look at the various aspects of cocaine jaw and it’s causes and effects on the general health of an individual with special emphasis on the oral cavity and jaw.

Coke jaw is an informal term that refers to the involuntary and uncoordinated movements of the jaw that are common in users of cocaine, particularly those who use the substance frequently or in large doses. This movement is often referred to as grinding, clenching, or twitching, and may occur during the period of cocaine use and the come down period [1].

Involuntary Movements: Coke jaw will result in what seems like the person is constantly moving or grinding the jaw, sometimes even vigorously.

Visible Effects: In the long run, changes in the movement of the jaw can be easily noticed by other people, and it is a clear indication that the person might be a user of cocaine.

The condition may be mild if a person uses small amounts of cocaine or if he or she has been using the drug for a short time. Some users might only have slight jaw movements, while others may have very severe and painful jaw movements.

The origin of the coke jaw can be attributed to the effect that cocaine has on the central nervous system, particularly how the drug impacts the muscles and nerves in the human body, including those in the face area.

Effects of cocaine on the body: Cocaine affects the brain by inhibiting the reabsorption of dopamine, serotonin, and norepinephrine, all of which are chemicals that control mood, movement, and sensation. Consequently, users get a boost in energy, feel happy, and are more alert. However, the overstimulation of the motor control of the body leads to muscle spasms and other involuntary movements which are evident in coke jaw.

Impact on muscles and nerves in the face: The effects of cocaine on the face include making the facial muscles and nerves contract or spasm in a manner that the user cannot control. The muscles in the jaw are the most affected by these effects since they are overused during the periods of drug use.

Involuntary jaw movement: The rhythmic, forceful movement that goes with the coke jaw is directly connected to how cocaine disrupts the body’s ability to regulate muscle contractions. It may be a subconscious action where the user does not know they are clenching their jaw and this becomes a conditioned response where the jaw clenches every time the drug is in the system.

The immediate and long-term effects of cocaine on the jaw include direct and indirect effects that are easy to notice and those that are latent and easily unnoticed.

Muscle Spasms and Clenching: One of the effects of cocaine that is likely to be observed in the first instance is the muscle twitches particularly in the facial region involving the jaw muscles. These spasms are sometimes not controlled and may lead to biting of the teeth. This can cause muscle fatigue and soreness of the muscles around the jaw and in the extreme cause long-term damage of the muscles.

Bruxism (Teeth Grinding): The coke jaw involves the constant grinding of the teeth, which can erode the enamel, the outer layer of the teeth that acts as a shield. This, in the long run, causes the teeth to become weak, and sensitive and even end up chipping or breaking [2].

Damage to Teeth and Gums: When users maintain this action of grinding or clenching their teeth, they are likely to cause harm to both their teeth and gums.

Worn Enamel: The constant rubbing of the teeth wears down the enamel and makes the teeth more susceptible to cavities and diseases.

Tooth Fractures: Chronic grinding also leads to the development of cavities in the teeth and may need the attention of a dentist to be corrected.

Gum Recession: The pressure that is applied on the teeth through clenching can also have an impact on the gums since they may recede and pull away from the teeth thus exposing the roots of the teeth and therefore more problems to the teeth.

Long-Term Effects On Jaw Health

Long-term effects of cocaine use on the jaw can be even more severe, as it causes more significant changes in the structure of the jaw. Such grinding and cramps cause conditions such as temporomandibular joint (TMJ) disorder that is a painful condition that affects the jaw joint and the muscles around it. TMJ can lead to a constant ache, audible noises in the jaw joint, and limited movement of the mouth [2].

At its worst, prolonged and forceful clenching can even result in jaw dislocation, which is a medical emergency. The implications of coke jaw are not only skin deep as they may be felt in the long run. Muscle tension, tooth damage, and gum problems can lead to a chronic pain which needs the intervention of a dentist.

Apart from jaw health, cocaine can cause several physical and mental health complications. We will briefly touch upon them.

Physical Health Issues

Cardiovascular Problems: Cocaine is notorious for having adverse effects on the heart and blood vessels. It increases blood pressure, and heart rate and constricts blood vessels which leads to chances of heart attack, stroke, and other problems related to the heart. Cocaine causes both acute and chronic effects on the heart; short-term effects include increased stress on the heart while long-term effects include arrhythmias, heart failure and sudden cardiac death [3].

Respiratory Issues: When inhaled or smoked, cocaine results in substantial harm to the lungs and respiratory system. Patients may develop a cough, difficulty in breathing, and the susceptibility to developing pneumonia and other related diseases. Long-term users may develop severe respiratory ailments such as chronic obstructive pulmonary disease (COPD).

Gastrointestinal Problems: Cocaine is also known to constrict blood vessels and this is not only confined to the heart. It can also alter the blood flow to the digestive system which may lead to ulcers, stomach pain, and other related complications. In extreme conditions, the blockage of blood flow to the intestines leads to the death of the tissue, and this is a very dangerous condition that needs medical attention [3].

Neurological Effects: Cocaine also affects the brain in a big way and this is especially so when one is using this substance in the long run. The drug stimulates the central nervous system and will make the user feel happy, be active and be alert. However, in the long-run, this overstimulation results in neurological disorders including seizures, stroke, and dementia. Long-term use also causes alteration in the brain’s reward system causing addiction and poor decision-making ability, memory, and concentration.

Mental Health Issues

Addiction and Dependence: Another severe effect of cocaine is that it is very addictive. Cocaine affects the brain’s reward system and makes users want more of the substance and hence become addicted to it. In the long run, the users become tolerant to the drug; this implies that they require a large amount of the substance to produce the required impact, thus leading to the likelihood of overdose and other related consequences. Cocaine addiction can be hard to break and is usually only overcome with help from a drug rehab center.

Anxiety and Paranoia: Cocaine can lead to anxiety and paranoid tendencies, which are something users with even a casual usage history are likely to experience. Long-term users may develop increased feelings of fear and suspicion and may even become paranoid or have hallucinations. It can affect their relationships and their everyday life as they may turn to be distrusting and be full of pranks.

Depression and Mood Swings: The effects of cocaine include euphoria, but after this high, the user comes down to a low characterized by depression, irritability, and fatigue. The chronic depression that comes with long-term use of cocaine is that users can never find joy in things that used to interest them. The fluctuations from high to low can be very straining psychologically thus making it difficult for the user to quit using the substance [3].

Psychosis: At its worst, cocaine can cause drug-induced psychosis, a state in which the user is out of touch with reality. This can include seeing things that are not real, hearing things that are not real, and acting unpredictably. Cocaine induced psychosis is more likely to be observed in chronic users or those who take large doses of the substance but can be seen in first time users as well.

Cocaine use and frequency affects the severity of the coke jaw. Let’s briefly categorize the severity of coke Jaws based on the usage of cocaine. 

Binge Use vs. Occasional Use: The intensity of coke jaw is also determined by the frequency and dosage of cocaine that is taken. In the case of occasional users, jaw clenching and grinding may only occur during or after the use of the drug while in the case of those who take the drug in binges, the symptoms are likely to be more severe and persistent [1].

Binge Use Impact: In binge sessions, users consume multiple doses of cocaine within a short time, thus sustaining the drug’s impact and maintaining the nervous system’s stimulation for hours or days. This prolongs the jaw muscle over activity, thus exposing the teeth, gums and TMJ to severe ravages. These symptoms may become long-term if the user continues with the bingeing and they are noticeable even when the user is not under the influence.

Chronic Use and Permanent Damage: In chronic users, the coke jaw is a constant problem; the patient experiences involuntary movements and jaw pain between cocaine uses. This constant overstimulation of the jaw muscles results in chronic contraction, TMJ disorder and possibly severe and irreversible harm to the oral cavity.

The route of administration of coke can affect the way it causes coke jaw. Here’s an overview of the different methods of cocaine administration:

Snorting vs. Smoking Cocaine: It has also been noted that the route of administration of cocaine can determine the probability and intensity of coke jaw. The most frequently used method is snorting which directly affects the nasal passages and the sinuses; however, as the cocaine’s stimulating effects travel through the body, it causes tension in the jaw muscles.

Smoking Crack Cocaine: Crack cocaine is a purer more potent and quicker acting form of the drug and is associated with more severe physical manifestations of the condition coke jaw. Smoking crack causes users to have a faster and more serious reaction of the involuntary jaw movement, clenching and grinding since it is absorbed directly into the blood stream. 

Crack cocaine is much more potent in its effects on the nervous system and therefore users are likely to find themselves with instances of rigor mortis like convulsions in the jaw and face muscles.

Oral Cocaine Use (Gum Rubbing): Some users put cocaine into the mouth and hold it between the cheek and the gum, a process called “gumming.” This may lead to localized anesthesia and inflammation of the mouth, which can lead to further damage to the gum and other tissues in the mouth. While not as frequent as snorting or smoking, this method still raises the risk of coke jaw, as the drug enters the bloodstream and similarly impacts the nervous system.

Various interventions and therapies have been proposed to deal with the coke jaw. Eradicating the root cause; cocaine addiction is often the primary goal. Prevention is the best strategy. 

Dental Interventions

The initial management of coke jaw involves treating the dental injuries that the condition may have caused. The extent of the damage may determine the treatments that the dentists may suggest to the patients.

Tooth Repair and Restoration: In case of extensive tooth wear, fillings, crowns, or veneers may be required to restore the teeth. In more severe cases, the users may need to have the missing teeth replaced by dental implants or dentures.

Treatment for Gum Disease: Coke jaw can lead to gum diseases and thus, if this has happened, the dentist may recommend deep cleanings, scaling, and root planning to eliminate the plaques. In severe conditions, one may require surgery to correct the problem affecting the gum tissue.

Therapy

Therapy of TMJ dysfunction associated with coke jaw is usually complex and may need specific care. 

Therapies to reduce pain and improve jaw mobility may include:

Physical Therapy: Simple exercises that focus on the muscles that are in and around the TMJ can help reduce pain and increase the range of motion.

Oral Appliances: Mouthguards or splints can be recommended by the dentists to avoid grinding during the night and lessen the pressure on the TMJ. These devices assist in preventing the teeth from further wear and may also provide relief to the jaws.

Botox Injections: Sometimes, it can be used to paralyze the muscles that are overactive and cause the jaw to move constantly. Botox works by partially immobilizing the muscles that cause clenching so that it can help limit spasms and jaw stiffness.

Coke Jaw And Addiction: A Path To Long-Term Recovery

Quitting Cocaine: The only known cure for the progression of coke jaw is to cease the use of cocaine. It is always a long process to get rid of cocaine addiction and this needs medical attention, behavioral therapy, and support groups. Because the body is physically and psychologically addicted to cocaine, the treatment process usually involves treating the addiction and the effects it has on the body.

Detoxification: The first process that must be undertaken to stop using cocaine is the withdrawal process, also known as detoxification. The withdrawal symptoms that are associated with detox are fatigue, depression, anxiety, and physical discomfort. It is therefore advisable to seek medical advice to help in dealing with such symptoms during the process.

Cognitive-Behavioral Therapy (CBT): CBT is an effective treatment for cocaine addiction since it enables the user to change the process of thinking that leads to the usage of cocaine and other related substances. Thus, through the treatment of the psychological problems, the users are able to change their behavior and find other ways of dealing with their problems besides using cocaine.

Addressing Physical Consequences: Besides combating addiction, users have to deal with the physiological effects of the substances they take. This may entail periodic dental treatment, continued TMJ treatment, and any medical care that may be required due to the effects of cocaine such as heart complications or respiratory disorders.

In addition to causing severe oral health issues, cocaine use leads to multiple physical and mental health issues that can impact different systems in the body. These effects are cumulative and may lead to long-term health complications.

1. Healthline. How Cocaine Impacts Your Teeth and Mouth. https://www.healthline.com/health/substance-use/cocaine-teeth

2. National Library Of Medicine. Oral motor parafunctions among heavy drug addicts and their effects on signs and symptoms of temporomandibular disorders. https://pubmed.ncbi.nlm.nih.gov/11889649/

3. Cleveland Clinic. Cocaine (Crack). https://my.clevelandclinic.org/health/articles/4038-cocaine-crack

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